Department of Oral Surgery, University of Sarajevo-Faculty of Dentistry with Dental Clinical Center, Bosnia and Herzegovina. ORCID ID https://orcid.org/0000-0003-4808-703X.
Department of Restorative Dentistry with Endodontics, University of Sarajevo-Faculty of Dentistry with Dental Clinical Center, Bosnia and Herzegovina.
Acta Med Acad. 2023 Aug;52(2):77-87. doi: 10.5644/ama2006-124.407.
This study aimed to analyze the crown and root morphology of maxillary and mandibular third molars, and assess their position in relation to adjacent anatomical structures using clinical examination and radiographic images.
A total of 176 extracted impacted or partially impacted third molars were included in this study. Orthopantomogram images (OPG) were used to evaluate the number of roots, position, depth of impaction relative to the occlusal plane of the second molar, and angulation of maxillary and mandibular third molars. The extracted teeth were examined to determine the actual number of roots. The root morphology was classified using the Alavi classification system for maxillary third molars and the Machado classification for mandibular third molars. Additionally, the number of cusps, crown dimensions, and morphology were analyzed using digital and dental calipers.
The extracted samples exhibited a significantly higher number of roots compared to the number assessed on OPG images (P<0.001). The majority of mandibular third molars had two fused roots (37.39%) and a five-cuspid crown (48.70%), while maxillary third molars had three fused roots (26.23%) and four cusps (42.62%). Both maxillary (60.66%) and mandibular third molars (61.74%) were predominantly vertically positioned. Regarding the depth of impaction, maxillary third molars were primarily classified as Class C (65.57%), while mandibular third molars were classified as Class B (47.83%). Differences in crown shape were observed, with maxillary crowns being mostly triangular (36.07%) and mandibular crowns being oval (38.26%). Maxillary third molars had shorter crowns compared to mandibular third molars (P<0.05).
The root morphology of maxillary and mandibular third molars in the population of Bosnia and Herzegovina displays variability. Orthopantomogram imaging was found to be inadequate for accurate determination of the number of roots in third molars. The number of cusps on third molars cannot be relied upon as a predictor of the number of roots. The study's findings will have implications for dental practice, particularly for oral surgeons and restorative dentists.
本研究旨在通过临床检查和影像学图像分析上颌和下颌第三磨牙的牙冠和牙根形态，并评估其与相邻解剖结构的位置关系。
本研究共纳入 176 颗拔除的埋伏或部分埋伏第三磨牙。使用全景片（OPG）评估第三磨牙的牙根数量、位置、相对于第二磨牙咬合平面的阻生深度以及上颌和下颌第三磨牙的倾斜角度。对拔除的牙齿进行检查以确定实际的牙根数量。使用 Alavi 分类系统对上颌第三磨牙的牙根形态进行分类，使用 Machado 分类系统对下颌第三磨牙的牙根形态进行分类。此外，使用数字卡尺和牙科卡尺分析牙冠的牙尖数量、牙冠尺寸和形态。
与 OPG 图像评估的数量相比，拔除样本的牙根数量明显更高（P<0.001）。大多数下颌第三磨牙有两个融合根（37.39%）和五牙尖牙冠（48.70%），而上颌第三磨牙有三个融合根（26.23%）和四个牙尖（42.62%）。上颌（60.66%）和下颌第三磨牙（61.74%）主要为垂直位置。关于阻生深度，上颌第三磨牙主要分类为 C 类（65.57%），而下颌第三磨牙分类为 B 类（47.83%）。牙冠形状存在差异，上颌牙冠多为三角形（36.07%），下颌牙冠多为椭圆形（38.26%）。上颌第三磨牙的牙冠比下颌第三磨牙短（P<0.05）。
波黑人群的上颌和下颌第三磨牙的牙根形态存在变异性。全景片成像不适用于准确确定第三磨牙的牙根数量。第三磨牙的牙尖数量不能作为牙根数量的预测指标。本研究结果将对口腔实践产生影响，特别是对口腔颌面外科医生和修复牙医。
